Radio waves ease heartburn agony

Radio waves are being used in a new treatment for heartburn - using small wires to generate heat and stiffen loose tissue, stopping the backflow of stomach acids.

In trials, it helped three-quarters of patients, with seven in ten either no longer requiring drugs or needing to take them only occasionally when symptoms appeared. Before treatment, patients were taking them twice a day.

Gastro-oesophageal reflux disease (GORD) is when the stomach contents flow back up into the oesophagus, causing a burning sensation known as heartburn.

Between the oesophagus and the stomach is a one-way valve or sphincter, made of muscle, which allows material to pass into the stomach but which should stop it flowing back.

In people with GORD, the valve does not work properly, allowing backflow of acidic stomach juices. Unlike the stomach, the oesophagus does not have a protective lining and is irritated by the acid, resulting in the burning sensation usually felt in the centre of the chest.

It is estimated as many as one in three adults may have symptoms of the condition at some time, and sufferers in the UK spend more than £800m a year on over-the-counter treatments for heartburn and indigestion.

Treatments include antacids, proton pump inhibitors or PPIs and H2 blockers, which neutralise or reduce the amount of acid made in the stomach. It's estimated that in around 20 per cent of patients, medication does not control symptoms.

In severe cases, surgery can be used to tighten and strengthen the ring of muscle. However, the new radio frequency treatment is far less invasive.

It is based on the idea that tissue - in this case at the junction of the oesophagus and upper stomach - can be stiffened by the body's natural responses to injury. A similar principle is used to stiffen tissue in the throat to treat snoring and sleep apnoea.

In the procedure, carried out as day surgery and taking around one hour, the patient is sedated and a flexible catheter or tube passed down through the throat to the lower part of the oesophagus.

The catheter has a number of sharp elements or thin wires at the extreme end which are manoeuvred so they penetrate 1-2mm into the oesophageal sphincter. Normally this tissue is taut and firm, but in GORD can wipe out patients it is loose and flabby.

Once in place, the elements or wires transmit high-frequency radio waves into the muscle tissue, raising its temperature.

This is repeated in different positions. The heating results in inflammation, which causes the muscle tissue to thicken.

Constant monitoring with remote sensors ensures there is no overheating, while chilled water is circulated to prevent other tissue being heated.

Researchers say patients have fully recovered by the next day. Latest research shows the treatment can be highly effective.

Doctors in Hanover, Germany, who led a study involving 60 patients at six centres, found that 12 months after treatment, 75 per cent of patients needed no medication or less medication than before treatment.

The device used in the trials is not currently available, but a new device incorporating radiofrequency technology for treating heartburn is expected to be available within the next 12 months.

Dr Chris Fraser, consultant gastroenterologist at the Wolfson Unit for Endoscopy, St Mark's Hospital, Harrow, said: 'Radiofrequency is one of a number of exciting new options for patients, many of whom want an alternative to medication. New non-surgical techniques like radiofrequency are attractive to patients.'